Supporting Clients with Mental Health Problems: The Career Practitioner s Role

Transcription

1 Supporting Clients with Mental Health Problems: The Career Practitioner s Role Neasa Martin & Kathy McKee Cannexus Conference, January 24th 2012, Ottawa, ON

2 Project s Roots

3 Project context

4 MH work-related costs Fastest growing occupational disability Cost to Canadian economy $14.4 B lost productivity $18.6 B substance abuse Focus is on workplace mental health

5 Understanding stigma & discrimination:

6 What is stigma & why does it exist?

7 Stigma Attribution Model 1. Labeling: Characteristics signal important difference. 2. Stereotyping: Differences linked to undesirable characteristics. 3. Separating: Distinction between normal & labeled group creating them & us. 4. Status loss: Devaluing, rejecting, discriminating & excluding.

8 Decade of the Broken Brain

9 Self-stigma is common

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11 Contact is most effective Contact is common - disclosure is not - creates a distorted image Relationship of equal status Context of cooperation Opportunity for discussion Credible presenters - disabuse common myths

12 What works to reduce stigma?

13 Social inclusion is the journey towards greater participation and citizenship

14 Survey Findings:

15 Project Approach May 2011 Sept May 2012

16 Survey tool

17 Who participated? 266 survey participants in total (81.5% completion) 176 Career practitioners 46% report having mental health problems/illness (65) 90 Clients 62% report having mental health problems/illness (56) 100 stakeholders participated in 5 regional meetings Meeting of 25 Career Resource Centre Managers

18 Contact is common - 1 in 5

19 Only those close to the person would ever know they are experiencing a mental health problem Client Career Practitioner contact with MHP/MI % Yes Co-worker 86% Close family/friends member 78% Personal experience 46% Client contact with MHP/MI % Yes Co-worker 78% Close friend 77% Close family member 71% Contact is common

20 Disclosure is not

21 Disclosure People disclose when they feel safe LIKELY to DISCLOSE LIKELY to be ACCEPTING Spouse 92% 90% Family 90% 80% Friend 88% 82% Guidance/Career 80% 68% Teachers 50% 46% Work-mates 31% 24% Employers 28% 22% Neighbours 21% 18%

22 To help clients Career Practitioners need to know Impact of stigma on work (99%) over 90% agree mental illness (99%) About Mental health About Skills in Work-related How to support About About resources (98%) peer support (97%) motivating clients (96%) coaching (95%) employers recovery (94%) practices (89%) treatment for MI (79%)

23 Clients rating vs Career Practitioners Knowledge of mental health Making right referrals Recommend peer support Comfort working with clients Discussing +/- disclosure Understanding & explaining rights Across all categories Career Practitioners rate themselves higher than Clients

24 Client rating cont Strongly/Agrees Career Practitioners: Share tools for coping with work Good support & access work/training Have knowledge to help me re: work LESS likely to refer clients for training 50% 35% 33% 28%

25 Satisfaction working with clients Same as with all clients Seeing progress Supporting change Gaining trust Helping clients get / maintain job Support people to reach their goals Improving self-esteem Supporting greater social inclusion

26 Frustrations working with clients

27 Barriers to employment Sometimes (stigma and discrimination) is very apparent and other times it is hidden but lurking below the surface. I was once told at a workplace that I would advance no further in my career because of my mental illness. When I was first diagnosed with schizophrenia in my early 20's, I went to what was then called the Manpower Office and asked for training. The counselor told me there were no training opportunities for me because I was chronically ill with schizophrenia.

28 Impact of mental health problems? Client rating Self-confidence Finances Employment Community involvement Family relationship Friendships 98% 96% 91% 91% 81% 78%

29 Have you seen workplace discrimination? Clients: 90% - Yes Happens all the time Career Practitioners: 48% - Yes Quit being paranoid

30 Clients agree Agree discrimination is common (96% vs 76%) Few feel fairly treated by employers (< 7%) Agree work improves mental health (89% vs 80%) Agree recovery is possible (87% vs 76%) Have hope they will work (79%) Don t need to be symptom free to work (76% vs 86%) Agree mental health problems make work stressful (52%) Career Practitioners disagree less reliable employees (86%)

31 In client / counselor relationship very/important 90% CLIENTS agree choices Given Believes my Can trust my counselor (91%) Feel respected Treated My Listen Inspires Feel care & (91%) capacity fairly to recover (94%) (94%) privacy is respected (93%) without judgment (91%) hope (91%) compassion (84%) (91%)

32 Strong agreement on how to help Treat People Like People Not a Disorder Include us as partners in planning

33 Where would clients prefer to receive career planning service? 43% 23% 18% 16%

34 Career Practitioner Training Needs

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36 Take away messages

37 Last Words Have your people not be therapists...but be knowledgeable about the clients they are trying to help integrate back into society. We want to be part of the workforce but may only dip our toes in and then back away, come back and test the water again...several times before we are really ready. HAVE PATIENCE...we will jump in when we are ready, just offer the tools and services so that we can make an informed decision. Do not force us. We have enough struggles already, this has to be something that we do for ourselves...and we will...trust me! :0)

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39 Stigma & Discrimination Related readings Bio-medical framing Angermeyer M, Matschinger H. Causal beliefs and attitudes to people with schizophrenia: trend analysis based on data from two population surveys in Germany. Br J Psychiatry 2005;186: B. Schulze. (2007) Stigma And Mental Health Professionals: A Review Of The Evidence On An Intricate Relationship; International Review Of Psychiatry; 19 2 ; Arthur Crisp, Liz Cowan and Deborah Hart. (2004) The College's Anti-Stigma Campaign, : A shortened version of the concluding report; Psychiatric Bulletin; 28 4 ; Read, J. & Harre, N. (2001). The role of biological and genetic causal beliefs in the stigmatization of mental patients. Journal of Mental Health, 10, Stigma Related Attitudes and Beliefs in the United States " Presented by Bruce G. Link, Stigma in Mental Health and Addiction, delivered in Calgary, June 3, Schnittker, J. (2008) An uncertain revolution: Why the rise of a genetic model of mental illness has not increased tolerance. Social Science & Medicine, 67(9), Read J, Haslam N, Sayce L, Davies E. (2006) Prejudice and schizophrenia: a review of the mental illness is an illness like any other approach. Acta Psychiatr Scand: 114: Phelan, J., Cruz-Rojas, R. and Reiff, M. (2002) Genes and stigma: the connection between perceived genetic etiology and attitudes and beliefs about mental illness, Psychiatric Rehabilitation Skills, 6(2): Ross M. G. Norman, Richard M. Sorrentino, Deborah Windell, Rahul Manchanda. (2008) The role of perceived norms in the stigmatization of mental illness. Social Psychiatry and Psychiatric Epidemiology Online publication date: 23-Jul Walker I. And Read J. (2002) The differential effectiveness of psychosocial and biogenetic causal explanations in reducing negative attitudes toward "mental illness"; Psychiatry-Interpersonal And Biological Processes; 65 4 ; Bernice Pescosolido, Stigma in Global Context: Fourth International Conference on Stigma (Jan. 2009) London, England Corrigan PW. How clinical diagnosis might exacerbate the stigma of mental illness. Soc Work Jan;52(1):31-9. LAM Danny C. K., SALKOVSKIS Paul M.; An experimental investigation of the impact of biological and psychological causal explanations on anxious and depressed patients perception of a person with panic disorder, Behaviour Research and Therapy Volume 45, Issue 2, February 2007, Pages

40 Education & changing attitudes Spagnolo, A. B. Murphy A. A. and Librera L. A.. (2008) Reducing stigma by meeting and learning from people with mental illness; Psychiatr.Rehabil.J.; 31 3 ; Nagel, T, Thompson, C, (2007) AIMHI NT Mental Health Story Teller Mob : Developing stories in mental health, Australian e-journal for the Advancement of Mental Health, vol 6, issue 2 Chang, C, Increasing Mental Health Literacy via Narrative Advertising, (2008) Journal of Health Communication, 13:37-55 Angermeyer, M. C., & Schulze, B. (2001). Reducing the stigma of schizophrenia: Understanding the process and options for interventions. Epidemiologia e Psichiatria Sociale, 10(1), 1-7. T. M. Lincoln, E. Arens, C. Berger and W. Rief. (2008) Can anti-stigma campaigns be improved? A test of the impact of biogenetic vs psychosocial causal explanations on implicit and explicit attitudes to schizophrenia; Schizophr.Bull.; 34 5 ; Self-stigma Lauber, C. Anthony, M. Ajdacic-Gross, V., Rössler, W. (2004) What about psychiatrists' attitude to mentally ill people? European Psychiatry. Volume 19, Issue 7, November, Pages Link, B. Mirotznik, J & Cullen, F. (1991). The effectiveness of stigma coping orientations: Can negative consequences of mental illness labelling be avoided. Journal of Health and Social Behavior. 32(3), p Hyman, I. (2008) Self-Disclosure and Its Impact on Individuals Who Receive Mental Health Services. Substance Abuse and Mental Health Services Administration. Otto F. Wahl, Ph.D. Mental Health Consumers' Experience of Stigma Schizophrenia Bulletin (3): ; Fighting Shadows: Self-Stigma And Mental Illness: Whawhai Atu te Whakamâ Hihira Corrigan, P. (2001). Don t call me nuts: Coping with stigma and mental illness. Tinley Park, Ill: Recovery Press. Corrigan, P.W., Larson, J.E., Nicolas Rusch, N. (2009) Self-stigma and the why try effect: impact on life goals and evidence-based practices. (World Psychiatry 2009;8:75-81)